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1.
Quintessence Int ; 51(2): 170-177, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31942577

RESUMO

OBJECTIVE: Some patients with Down syndrome experience premature edentulism, which can lead to severe alveolar atrophy. This may cause retention problems with purely mucosa-supported dentures and ill-fitting total dentures. The intellectual disability associated with Down syndrome, with an (implied) inadequate ability for compliance, may pose a further challenge to dental treatment. The aim of this case report was to demonstrate that a combined implant-prosthetic denture with bar constructions can, nevertheless, be implemented in elderly Down syndrome patients with limited cooperation ability. METHOD AND MATERIALS: This report is the first to describe the procedure for an implant-supported total prosthetic restoration with bar joint in a 52-year-old edentulous patient with Down syndrome and limited ability to cooperate. Previous dental solutions had severely curtailed the patient's quality of life. By combining various forms of treatment, including behavior management, the course of therapy could be adapted to the patient's cooperation capability. RESULTS: The implant-supported total prosthetic restoration with bar joint was well accepted by the patient. Moreover, the patient's relatives reported that his life quality had improved distinctly (eg, considerable weight-gain, more positive mood). No impairments of the prostheses were observed during the 24-month follow-up period, and both implants remained clinically inconspicuous. CONCLUSION: The lack, or inadequacy, of dental prostheses can impair the life quality of individuals in need of such restorations. Implant-supported dentures in combination with a bar construction improve the retention of prostheses in atrophied jaws. This form of restoration is also proving to be a successful therapy option for elderly persons with Down syndrome.


Assuntos
Implantes Dentários , Síndrome de Down , Arcada Edêntula , Idoso , Prótese Dentária Fixada por Implante , Falha de Restauração Dentária , Revestimento de Dentadura , Seguimentos , Humanos , Pessoa de Meia-Idade , Qualidade de Vida , Resultado do Tratamento
2.
Br J Oral Maxillofac Surg ; 57(9): 831-838, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31405600

RESUMO

Fabry disease and Pompe disease are rare lysosomal storage disorders that belong to a heterogeneous group of more than 200 distinct inborn metabolic diseases. Mutations followed by loss of function of enzymes or transporters that are localised in the acidic environment of the lysosome may result in degradation of many substrates, such as glycosaminoglycans, glycosphingolipids, glycogen, cholesterol, oligosaccharides, glycoproteins, and peptides, or the excretion of the products degraded by the lysosome. Our aim was to identify the oral signs and symptoms of Fabry disease and Pompe disease from a systematic review made using MEDLINE/PubMed, and a hand search for relevant articles, following the PRISMA guidelines. Both diseases show various craniofacial and oral changes, including supernumerary teeth, dental agenesis, angiokeratoma, and telangiectases in Fabry disease; and macroglossia, teeth fusion, and taurodontism in Pompe disease. Common clinical signs of Fabry disease include hyposalivation, hypohidrosis, and xerophthalmia, and a generally reduced physical resilience was apparent in patients with Pompe disease. Oral and craniofacial changes in patients with both diseases extend over their entire lifetime and can be detected even in an infant. Lysosomal storage diseases should be taken into consideration in the differential diagnosis of relevant diverse symptoms, because treatment, when available, is most effective when started early. The main therapeutic concepts are enzymatic replacement for Pompe disease, whereas patients with Fabry disease require additional oral chaperone treatment or enzyme replacement.

3.
Materials (Basel) ; 12(17)2019 Aug 27.
Artigo em Inglês | MEDLINE | ID: mdl-31461861

RESUMO

The aim of this in vitro pilot study was to analyse the adhesion behaviour of human osteoblasts and fibroblasts on polyether ether ketone (PEEK) when compared with titanium surfaces in an inflammatory environment under lipopolysaccharide (LPS) incubation. Scanning electron microscopy (SEM) images of primary human osteoblasts/fibroblasts on titanium/PEEK samples were created. The gene expression of the LPS-binding protein (LBP) and the LPS receptor (toll-like receptor 4; TLR4) was measured by real-time polymerase chain reaction (PCR). Immunocytochemistry was used to obtain evidence for the distribution of LBP/TLR4 at the protein level of the extra-cellular-matrix-binding protein vinculin and the actin cytoskeleton. SEM images revealed that the osteoblasts and fibroblasts on the PEEK surfaces had adhesion characteristics comparable to those of titanium. The osteoblasts contracted under LPS incubation and a significantly increased LBP gene expression were detected. This was discernible at the protein level on all the materials. Whereas no increase of TLR4 was detected with regard to mRNA concentrations, a considerable increase in the antibody reaction was detected on all the materials. As is the case with titanium, the colonisation of human osteoblasts and fibroblasts on PEEK samples is possible under pro-inflammatory environmental conditions and the cellular inflammation behaviour towards PEEK is lower than that of titanium.

4.
Artigo em Inglês | MEDLINE | ID: mdl-30857312

RESUMO

Background: The object of this paper was to provide an overview of rare diseases (RDs) with periodontal manifestations and allocate them to relevant categories. Methods: In ROMSE, a database for "Rare Diseases with Orofacial Involvement", all 541 entities were analyzed with respect to manifestations of periodontal relevance. Inclusion criteria were periodontally relevant changes to the oral cavity, in accordance with the 2018 version of the Classification of Periodontal and Peri-Implant Diseases and Conditions. Rare diseases were recorded, using the methodology described, and subsequently compared with the Orphanet Classification of Rare Diseases. Results: A total of 76 RDs with periodontal involvement were recorded and allocated in accordance with the Classification of Periodontal and Peri-Implant Diseases and Conditions. Of the 541 RDs analyzed as having known orofacial manifestations, almost 14 percent indicated a periodontally compromised dentition. Conclusions: Around 14 percent of RDs with an orofacial involvement showed periodontally relevant manifestations, which present not only as a result of gingivitis and periodontitis, but also gingival hyperplasia in connection with an underlying disease. Thus, dentists play an important role in therapy and early diagnoses of underlying diseases based on periodontally relevant manifestations.


Assuntos
Doenças Periodontais/complicações , Doenças Raras/complicações , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Dente
5.
Quintessence Int ; 50(2): 114-124, 2019 01 25.
Artigo em Inglês | MEDLINE | ID: mdl-30564806

RESUMO

The aim of this study was to evaluate long-term outcomes in a 10-year follow-up study of patients who previously completed a 3-year multicenter randomized controlled trial of immediate and early loading of dental implants with a hydrophilic and chemically active surface (SLActive) in the posterior maxilla or mandible. The patients received implants to replace at least one missing tooth, with provisional restoration on the day of surgery (immediate loading) or 28 to 34 days later (early loading). Implant survival, change in crestal bone level, and patient satisfaction were evaluated. In total, 56 patients (with 72 implants) were available after 10 years and fulfilled the criteria for the radiographic bone level evaluation. The mean crestal bone level change from implant surgery to 10 years was -2.00 ± 1.19 mm and -1.37 ± 1.06 mm in the immediate and early groups, respectively. The corresponding change between 5 to 6 months' post-surgery (permanent fixed restoration placement) and 10 years was -1.25 ± 0.99 mm and -0.89 ± 1.11 mm in the immediate and early groups. After the initial remodeling phase (5 to 6 months) where the depth of implant placement had an influence on the initial bone remodeling, no significant differences between the two treatment groups were detected. Mean implant survival was 97.6% (98.2% and 97.1% in the immediate and early loading groups, respectively). Implants with the SLActive surface show successful long-term outcomes following immediate or early loading in posterior maxillae and mandibles.


Assuntos
Perda do Osso Alveolar/etiologia , Falha de Restauração Dentária , Carga Imediata em Implante Dentário , Satisfação do Paciente , Ataque Ácido Dentário , Adulto , Idoso , Perda do Osso Alveolar/diagnóstico por imagem , Materiais Revestidos Biocompatíveis , Prótese Dentária Fixada por Implante , Restauração Dentária Temporária , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Propriedades de Superfície , Resultado do Tratamento
6.
J Prosthet Dent ; 120(2): 299-302, 2018 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-29551375

RESUMO

A female patient, now aged 17 years, was diagnosed with rhabdomyosarcoma (RMS) in the right pterygopalatine fossa when she was 3 years old. The RMS was successfully treated by excision, but the subsequent radiation and polychemotherapy resulted in the complete anesthesia of the distribution area of the right trigeminal nerve and loss of vision in the right eye. The patient also experienced pain in the mandibular joints and masticatory muscles. Panoramic radiographs displayed a multiple agenesia of the permanent teeth and underdeveloped apices. Treatment involved the fabrication of a complete maxillary denture. A removable device was fabricated to evaluate her response to an occlusal vertical dimension increase of 6 mm and provide a stable intercuspal position. After wearing the prosthesis for 6 months, the patient reported that she was completely free of symptoms.


Assuntos
Oclusão Dentária , Prótese Total , Arcada Edêntula/reabilitação , Rabdomiossarcoma Embrionário/complicações , Dimensão Vertical , Adolescente , Pré-Escolar , Feminino , Humanos , Arcada Edêntula/etiologia , Mandíbula/diagnóstico por imagem , Músculos da Mastigação/diagnóstico por imagem , Músculos da Mastigação/fisiologia , Maxila/diagnóstico por imagem , Placas Oclusais , Radiografia Panorâmica
7.
Aust Endod J ; 43(1): 29-33, 2017 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-27238158

RESUMO

To determine whether the selection of retrograde filling material or the choice of instruments in root tip resection influences the seal of the retrograde root filling. Seventy-two single-rooted teeth were used. Root resection was performed using a Lindemann bone cutter, a Lindemann bone cutter with A-shaped cutting design or a diamond-coated bur. Retro-cavities were prepared by piezo-tips and filled with Super-EBA or MTA. Teeth were made transparent and dye penetration was assessed. Teeth filled with MTA, irrespective of the resection instrument, showed no measurable dye penetration. All groups filled with Super-EBA showed an apical leakage. There were no significant differences between the three groups filled with Super-EBA (P = 0.09). The comparison of MTA versus Super-EBA showed significant superiority in apical seal in favour of MTA (P < 0.0001). To use MTA as a retrograde filling material showed superior results in terms of the tightness of the apical seal as compared to Super-EBA.


Assuntos
Materiais Restauradores do Canal Radicular , Compostos de Alumínio , Compostos de Cálcio , Infiltração Dentária , Óxidos , Obturação Retrógrada , Silicatos
8.
Clin Implant Dent Relat Res ; 17(2): 234-46, 2015 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-23837502

RESUMO

PURPOSE: The aim of this investigation was to evaluate the 3-year outcomes regarding crestal bone level, clinical parameters, and patient satisfaction, following submerged and transmucosal implant placement for two-piece implants in the anterior maxilla and mandible. MATERIALS AND METHODS: Patients requiring dental implants for single-tooth replacement in the anterior maxilla or mandible were enrolled in a randomized, controlled, multicenter clinical trial. The implants were randomized at placement to either submerged or transmucosal healing, with final restorations placed after 6 months. Radiographic and clinical parameters were recorded after 1, 2, and 3 years; a questionnaire was also used to assess patient satisfaction. A two-sided, unpaired T-test (significance level p ≤ .05) was used to statistically evaluate the differences between the two groups. RESULTS: A total of 106 patients were included in the 3-year analysis. The mean change in crestal bone level from implant placement to 3 years was 0.68 ± 0.98 mm (p < .001) and 0.58 ± 0.77 mm (p < .001) in the submerged and transmucosal groups, respectively; the differences between the groups were not significant. Clinical parameters remained stable throughout the study, with no significant differences between the groups, and patient satisfaction was good or excellent for over 90% of subjects in both groups. CONCLUSIONS: The results demonstrate excellent clinical and radiographic conditions after 3 years for implants supporting single-tooth restorations, regardless of whether a submerged or transmucosal surgical technique was used.


Assuntos
Implantação Dentária Endo-Óssea/métodos , Implantes Dentários para Um Único Dente , Idoso , Perda do Osso Alveolar/diagnóstico por imagem , Estética Dentária , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Satisfação do Paciente , Inquéritos e Questionários , Resultado do Tratamento
9.
Cell Commun Adhes ; 21(5): 241-7, 2014 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-24946183

RESUMO

Bisphosphonates (BPs) are drugs commonly used in the treatment of various disease arising or affecting bone tissue. There is a standard use in bone neoplasia and metastasis, hormonal and developmental disorders as well as for compensation of adverse effects in several medical therapies. Many in-vivo and in-vitro studies have assessed the efficacy of this drug and its function in cellular scale. In this concern, BPs are described to inhibit the resorptive function of osteoclasts and to prevent apoptosis of osteoblasts and osteocytes. They can preserve the osteocytic network, reduce fracture rate, and increase the bone mineral content, which is therapeutically used. Connexin 43 (Cx43) is a crucial molecule for basal regulation of bone homeostasis, development, and differentiation. It is described for signal transduction in many physiological and pathological stimuli and recently to be involved in BP action.


Assuntos
Conexina 43/química , Difosfonatos/química , Reabsorção Óssea , Diferenciação Celular/efeitos dos fármacos , Proliferação de Células/efeitos dos fármacos , Conexina 43/metabolismo , Difosfonatos/farmacologia , Difosfonatos/uso terapêutico , Junções Comunicantes/metabolismo , Humanos , Osteoblastos/metabolismo , Osteoclastos/metabolismo , Osteoporose/tratamento farmacológico , Osteoporose/metabolismo , Osteoporose/patologia , Ligação Proteica
10.
Oral Maxillofac Surg ; 18(3): 279-82, 2014 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-24756853

RESUMO

Severe hemorrhages of the oral cavity may be caused by arteriovenous malformations. This case report concerns a 52-year-old healthy female who presented with a painful lower third molar and an extensive arteriovenous high-flow malformation of the floor of the right side of the mouth. During the extraction of the right lower wisdom tooth, an episode of massive life-threatening bleeding occurred. Since the therapy for intraoral arteriovenous malformations of the soft tissue is complex and often difficult to perform, the modus operandi of the present case is presented, and a review of the literature is included.


Assuntos
Malformações Arteriovenosas/complicações , Dente Serotino/cirurgia , Hemorragia Bucal/etiologia , Extração Dentária/efeitos adversos , Feminino , Humanos , Lábio/irrigação sanguínea , Mandíbula/cirurgia , Artéria Maxilar/anormalidades , Pessoa de Meia-Idade , Soalho Bucal/irrigação sanguínea , Língua/irrigação sanguínea
11.
BMC Neurol ; 13: 114, 2013 Sep 03.
Artigo em Inglês | MEDLINE | ID: mdl-24138900

RESUMO

BACKGROUND: Only a few case reports and case series dealing with oral and dental health care are available in literature until now. The aim of the present pilot study was to determine the status of dental health in comparison to matched controls and to heighten the neurologists' and dentists' awareness of the oral aspects of the disease. METHODS: 42 Huntington's disease (HD) participants were scored according to the Unified Huntington's Disease Rating Scale. The dental status was assessed by using the well established score for decayed, missing, and filled teeth (DMFT) and the dental plaque score (Silness-Loe plaque index). RESULTS: Compared to controls HD participants showed significantly more decayed teeth and more plaques in both plaque indices. A higher motor impairment and a lower functional status of the patients lead to a worsening in dental status. CONCLUSION: Possible reasons for our findings are discussed. Apart from local oral complications general complications may also occur. Thus, as a consequence, we would encourage patients, caregivers, neurologists, and the dentists to ensure regular preventive dental examinations and dental treatments of individuals with Huntington's disease even in the premanifest stage of this disease.


Assuntos
Doença de Huntington/complicações , Saúde Bucal , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Projetos Piloto
12.
Clin Implant Dent Relat Res ; 15(4): 600-12, 2013 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-22171722

RESUMO

BACKGROUND: There is a lack of well-designed prospective, randomized clinical trials evaluating the efficacy of immediate and early loading of implants placed in the partially edentulous posterior maxilla or mandible. PURPOSE: The aim of this study was to evaluate crestal bone level changes over 3 years following immediate or early loading of Straumann implants with a chemically modified surface (SLActive®, Institut Straumann AG, Basel, Switzerland) placed in the posterior maxilla and mandible. MATERIALS AND METHODS: Subjects received temporary restorations immediately or 28 to 34 days after surgery, with permanent restorations placed at 20 to 23 weeks. Bone level changes were measured by comparison of standardized radiographs taken on the day of implant placement and 5, 12, 24, and 36 months thereafter. RESULTS: Two hundred thirty-nine of two hundred sixty-six patients (89.9%) completed the trial. Implant survival rates were 97.4% and 96.7% in the immediate and early loading groups, respectively (p = not significant). Over 36 months, the mean bone level change for immediately loaded implants was 0.88 ± 0.81 mm versus 0.57 ± 0.83 mm for the early-loaded group (p < .001). After adjusting for a slight difference in initial placement depth, the time of loading had no significant influence on bone level change. CONCLUSIONS: Changes in crestal bone level occurred mostly during the first 5 months postloading. After this bone remodeling period, crestal bone level was stable up to 36 months. Implants with a chemically modified surface are safe and predictable for immediate and early loading in the posterior maxilla and mandible.


Assuntos
Implantes Dentários , Planejamento de Prótese Dentária , Carga Imediata em Implante Dentário/métodos , Arcada Parcialmente Edêntula/cirurgia , Mandíbula/cirurgia , Maxila/cirurgia , Perda do Osso Alveolar/diagnóstico por imagem , Processo Alveolar/diagnóstico por imagem , Densidade Óssea/fisiologia , Remodelação Óssea/fisiologia , Coroas , Arco Dental/diagnóstico por imagem , Arco Dental/cirurgia , Restauração Dentária Temporária , Prótese Parcial Fixa , Prótese Parcial Temporária , Seguimentos , Humanos , Arcada Parcialmente Edêntula/reabilitação , Mandíbula/diagnóstico por imagem , Maxila/diagnóstico por imagem , Pessoa de Meia-Idade , Osseointegração/fisiologia , Radiografia Interproximal/métodos , Propriedades de Superfície , Análise de Sobrevida
13.
Eur J Oral Implantol ; 5(2): 123-36, 2012.
Artigo em Inglês | MEDLINE | ID: mdl-22866289

RESUMO

OBJECTIVES: This randomised, controlled multicentre trial aimed at comparing two versions of a variable-thread dental implant design to a standard tapered dental implant design in cases of immediate functional loading for 36 months after loading. MATERIALS AND METHODS: 177 patients (325 implants) were included at 12 study centres and randomly allocated into one of three treatment groups: NAI (variable-thread design, NobelActive internal connection), NAE (variable-thread design, NobelActive external connection) and, as control, NR (standard tapered design, NobelReplace tapered groovy). Inclusion criteria concerned healed bony implant sites and feasibility for immediate loading. Clinical and radiographic examinations were performed at implant placement and after 3, 6, 12, 24 and 36 months. The outcome measures were marginal bone remodelling (primary outcome), implant survival and success, papilla score, plaque accumulation, and bleeding on probing. RESULTS: 127 patients (NAI: 45, NAE: 41, NR: 41) were followed-up and evaluated after 36 months. No significant differences in cumulative survival rates were seen for the groups (NAI: 95.7%; NAE: 96.3%; NR: 96.6%). In all groups, bone remodelling occurred during the first 3 months, with stable or even increasing bone levels after the initial remodelling period. The bone remodelling from insertion to 36 months for the NAI group (-0.89 ± 1.65 mm) was comparable (P = 0.98) to that of the NR group (-0.85 ± 1.32 mm). The NAE group showed comparable bone remodelling during the first year, with an increase in following years resulting in significantly less overall bone loss (-0.16 ± 1.06 mm) (P = 0.041). Overall improvement in papilla size was observed in all treatment groups. CONCLUSIONS: Over 36 months, the results show stable or improving bone levels for all treatment groups after the initial bone remodelling seen during the first 3 months after placement. The variable- thread implants showed results comparable to those of standard tapered implants in cases of immediate function, and therefore can be considered as a treatment option for immediate loading.


Assuntos
Perda do Osso Alveolar/diagnóstico por imagem , Implantes Dentários , Planejamento de Prótese Dentária , Carga Imediata em Implante Dentário , Adulto , Perda do Osso Alveolar/etiologia , Remodelação Óssea , Implantação Dentária Endo-Óssea/métodos , Placa Dentária/etiologia , Falha de Restauração Dentária , Feminino , Seguimentos , Retração Gengival/etiologia , Humanos , Carga Imediata em Implante Dentário/efeitos adversos , Estimativa de Kaplan-Meier , Masculino , Pessoa de Meia-Idade , Peri-Implantite/etiologia , Índice Periodontal , Modelos de Riscos Proporcionais , Radiografia , Estatísticas não Paramétricas
14.
Clin Oral Implants Res ; 23(2): 211-219, 2012 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-21722188

RESUMO

OBJECTIVES: To test whether or not transmucosal healing at two-piece implants is as successful as submerged placement regarding crestal bone levels and patient satisfaction. MATERIAL AND METHODS: Adults requiring implants in the anterior maxilla or mandible in regions 21-25, 11-15, 31-35 or 41-45 (WHO) were recruited for this randomized, controlled multi-center clinical trial of a 5-year duration. Randomization was performed at implantation allowing for either submerged or transmucosal healing. Final reconstructions were seated 6 months after implantation. Radiographic interproximal crestal bone levels and peri-implant soft tissue parameters were measured at implant placement (IP) (baseline), 6 and 12 months. Patient satisfaction was assessed by a questionnaire. A two-sided t-test (80% power, significance level α=0.05) was performed on bone-level changes at 6 and 12 months. RESULTS: One hundred and twenty-seven subjects were included in the 12-month analysis (submerged [S]: 52.5%, transmucosal [TM]: 47.2%). From IP to 6 months, the change in the crestal bone level was -0.32 mm (P<0.001) for the S group and -0.29 mm (P<0.001) for the TM group. From IP to 12 months, bone-level changes were statistically significant in both groups (S -0.47 mm, P<0.001; TM -0.48 mm, P<0.001). The mean differences of change in the bone levels between the two groups were not statistically significant at either time point, indicating the equivalence of both procedures. For both groups, very good results were obtained for soft tissue parameters and for patient satisfaction. CONCLUSIONS: Transmucosal healing of two-piece implants is as successful as the submerged healing mode with respect to tissue integration and patient satisfaction within the first 12 months after IP.


Assuntos
Perda do Osso Alveolar/prevenção & controle , Implantação Dentária Endo-Óssea/métodos , Implantes Dentários , Mandíbula/cirurgia , Maxila/cirurgia , Cicatrização/fisiologia , Aumento do Rebordo Alveolar , Planejamento de Prótese Dentária , Feminino , Humanos , Masculino , Mandíbula/diagnóstico por imagem , Maxila/diagnóstico por imagem , Pessoa de Meia-Idade , Satisfação do Paciente , Radiografia , Inquéritos e Questionários , Resultado do Tratamento
15.
Spec Care Dentist ; 31(5): 178-81, 2011.
Artigo em Inglês | MEDLINE | ID: mdl-21950532

RESUMO

Parkinson's disease (PD) has been associated with aging, reduced fine motor skills, and malnutrition caused by eating soft sticky foods and a decreased liquid intake, which may contribute to the onset of caries, periodontal disease, and tooth loss. The objective of this study was to investigate the oral health of 101 patients with PD (mean age: 66.2 ± 10.5 years) and compare them to 75 control subjects (CO) (mean age 71 ± 10.53). Patients with PD had poorer oral health than the control group (papilla bleeding index: PD 6.97 ± 8.34; CO 2.12 ± 2.73). Lower frequencies of daily toothbrushing (PD: 1.69 ± 0.83; CO: 2.08 ± 0.80), longer time since the last dentist visit (PD: 1.94 ± 1.49; CO: 1.21 ± 0.60 years), and reduced salivary flow (PD: 2.69 ± 0.94; CO: 3.53 ± 1.11 ml). All of these factors may be related to the gingival recession and tooth mobility found in our patients with PD. Individuals with PD, their caregivers, and their physicians need to focus more on their oral health and quality of oral hygiene.


Assuntos
Cárie Dentária/classificação , Doença de Parkinson/complicações , Doenças Periodontais/classificação , Idoso , Coroas/estatística & dados numéricos , Assistência Odontológica/estatística & dados numéricos , Restauração Dentária Permanente/estatística & dados numéricos , Feminino , Hemorragia Gengival/classificação , Retração Gengival/classificação , Humanos , Masculino , Pessoa de Meia-Idade , Perda da Inserção Periodontal/classificação , Índice Periodontal , Bolsa Periodontal/classificação , Saliva/metabolismo , Taxa Secretória/fisiologia , Perda de Dente/classificação , Mobilidade Dentária/classificação , Escovação Dentária/estatística & dados numéricos
16.
J Prosthet Dent ; 101(5): 293-305, 2009 May.
Artigo em Inglês | MEDLINE | ID: mdl-19410064

RESUMO

STATEMENT OF PROBLEM: A tapered implant with continuously changing threads purported to provide stable tissue support and allow immediate function has been developed. Treatment success and stabilization of supporting tissues over time require documentation. PURPOSE: The purpose of this prospective, randomized, controlled, multicenter study was to evaluate changes in bone level and soft tissue behavior between the novel implant (NobelActive/NA) and a standard tapered implant (NobelReplace Tapered Groovy/NR) with regard to immediate function. MATERIAL AND METHODS: A total of 177 patients randomly allocated to 3 treatment groups (2 different test implant groups: NA Internal (n=117; internal connection) and External (n=82), and 1 standard treatment group, NR (n=126)) received 325 implants. Implants were placed into healed sites, and all but 6 implants were immediately nonocclusally loaded. Clinical and radiographic evaluations of treatment success, crestal bone levels, and soft tissue changes were performed at the time of placement and after 3, 6, and 12 months. Log-Rank test was used to analyze the differences in survival rate. Marginal bone level was compared using the Kruskal-Wallis test and Mann-Whitney U-test (alpha=.05). RESULTS: One-year cumulative survival rates were comparable (96.6% for NA Internal; 96.3% for NA External; 97.6% for NR; P=.852; Log-Rank). Mean (SD) change in bone level was -0.95 mm (1.37) for NA Internal, -0.64 mm (0.97) for NA External, and -0.63 mm (1.18) for NR (P=.589; Kruskal-Wallis). Stable soft tissues and significantly increased papilla scores (P<.001; Wilcoxon signed-rank) were observed for all implant types. CONCLUSIONS: The novel implants showed high survival rates as well as stable bone and soft tissue levels after 1 year, and may be recommended for clinical use, even under immediate function.


Assuntos
Remodelação Óssea , Implantes Dentários para Um Único Dente , Planejamento de Prótese Dentária , Prótese Dentária Fixada por Implante , Mucosa Bucal/anatomia & histologia , Adolescente , Adulto , Idoso , Processo Alveolar/diagnóstico por imagem , Densidade Óssea , Coroas , Implantação Dentária Endo-Óssea , Falha de Restauração Dentária , Prótese Total Imediata , Prótese Parcial Imediata , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Radiografia , Resultado do Tratamento , Adulto Jovem
17.
Clin Oral Implants Res ; 19(11): 1119-28, 2008 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-18983314

RESUMO

OBJECTIVE: Immediate and early loading of implants can simplify treatment and increase patient satisfaction. This 3-year randomized-controlled trial will therefore evaluate survival rates and bone-level changes with immediately and early loaded Straumann implants with the SLActive surface. MATERIAL AND METHODS: Partially edentulous patients >or=18 years of age were enrolled. Patients received a temporary restoration (single crown or two to four unit fixed partial denture) out of occlusal contact either immediately (immediate loading) or 28-34 days later (early loading group), with permanent restorations placed 20-23 weeks after surgery. The primary endpoint was change in crestal bone level from baseline (implant placement) to 12 months; the secondary variables were implant survival and success rates. RESULTS: A total of 383 implants (197 immediate and 186 early) were placed in 266 patients; 41.8% were placed in type III and IV bone. The mean patient age was 46.3+/-12.8 years. Four implants failed in the immediate loading group and six in the early loading group, giving implant survival rates of 98% and 97%, respectively (P=NS). There were no implant failures in type IV bone. The overall mean bone level change from baseline to 12 months was 0.77+/-0.93 mm (0.90+/-0.90 and 0.63+/-0.95 mm in the immediate and early groups, respectively; P<0.001). However, a significant difference in implantation depth between the two groups (P<0.0001) was found. After adjusting for this slight difference in initial surgical placement depth, time to loading no longer had a significant influence on bone-level change. Significant influence was found for: center (P<0.0001), implant length (P<0.05) and implant position (P<0.0001). Bone gain was observed in approximately 16% of implants. CONCLUSIONS: The results demonstrated that Straumann implants with the SLActive surface are safe and predictable when used in immediate and early loading procedures. Even in poor-quality bone, survival rates were comparable with those from conventional or delayed loading. The mean bone-level change was not deemed to be clinically significant and compared well with the typical bone resorption observed in conventional implant loading.


Assuntos
Perda do Osso Alveolar/etiologia , Materiais Revestidos Biocompatíveis , Implantação Dentária Endo-Óssea/métodos , Implantes Dentários , Planejamento de Prótese Dentária , Prótese Dentária Fixada por Implante , Ataque Ácido Dentário , Adulto , Perda do Osso Alveolar/diagnóstico por imagem , Coroas , Ligas Dentárias , Implantação Dentária Endo-Óssea/efeitos adversos , Falha de Restauração Dentária , Restauração Dentária Temporária , Análise do Estresse Dentário , Prótese Parcial Imediata , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Radiografia , Propriedades de Superfície , Fatores de Tempo , Titânio , Resultado do Tratamento
20.
J Dtsch Dermatol Ges ; 1(3): 199-203, 2003 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-16285495

RESUMO

BACKGROUND: Perioral dermatitis (PD) is a common dermatological disease whose aetiology and pathogenesis remain speculative. We investigated skin barrier function and various markers of the atopic diathesis to elucidate their impact on the development of perioral dermatitis. PATIENTS AND METHODS: Forty patients (24 to 69 years of age) with PD were evaluated. Transepidermal water loss was measured in three regions of the face (lateral chin, perinasal cheek and side of the nose) and the patients were assessed for clinical criteria for atopy. Prick tests were performed, and specific IgE against a mixture of aeroallergens (CAP SX1) was measured. The control group consisted of 62 individuals (20 to 68 years of age) without a history of PD or active disease. RESULTS: Transepidermal water loss was significantly increased (P < 0.001) on all regions of the face in the patient over the control group. Significantly (P < 0.001) higher values were also found for the patient group regarding history (52.5% vs. 17.7%) and clinical signs of atopic diathesis (> or = 4 features: 72.5% vs. 0%), prick test reactivity (> or = 2 reactive prick tests: 60% vs. 12.9%), and specific IgE against aeroallergens (CAP SX1 classes > or = 2: 60.0% vs. 17.7%). CONCLUSIONS: Our findings emphasize the relevance of impaired skin barrier function as a pathogenic factor in the causation of perioral dermatitis. The susceptibility of atopic skin to irritants increases as soon as the skin becomes eczematous. Therefore, we propose that atopic diathesis serves as an intensifier, supporting development and continued presence of perioral dermatitis after nonspecific irritant mechanisms have induced impaired skin barrier function.


Assuntos
Dermatite Atópica/diagnóstico , Dermatite Atópica/fisiopatologia , Dermatite Perioral/diagnóstico , Dermatite Perioral/fisiopatologia , Absorção Cutânea , Pele/fisiopatologia , Perda Insensível de Água , Adulto , Idoso , Dermatite Atópica/complicações , Dermatite Perioral/etiologia , Suscetibilidade a Doenças/complicações , Suscetibilidade a Doenças/diagnóstico , Suscetibilidade a Doenças/fisiopatologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
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